© David Sponder, L.E.P., BCBA, RDI CC, Floortime C1
Executive Director, Sponderworks Children’s Services

Floortime Techniques Related to the ‘D’ or Developmental Aspect of DIR

Note: There is a great deal of overlap between the domains of DIR. There is no real need for clean demarcation, as there is no such thing in development or in these aspects of human beings writ large.  Therefore, the Floortime techniques we associate with a particular domain of DIR could easily apply to any of the other of its domains.

Technique: Developing and Maintaining the ‘Joint Attention Triangle’

In Floortime, we always want to be part of the child’s attention.  We want to become an integral part of the child’s moment to moment reference point.  Instead of the child just focusing on herself or on some action or object (one or two points of reference), we want three points of reference: the child, you, and some shared reference.  We give you tips on what Joint Attention (JA) is and how it works, as well as how to facilitate your remaining a part of the child’s attention in other articles on this site.  Getting and keeping a joint attention triangle going is challenging with children with disorders of relating and communicating (autism spectrum or attachment disorders).  They can have difficulties with every level of perspective taking.  Remediation involves increasing the individual’s ability to share attention, thinking, and experience with others.  This is very different than a singular focus on teaching a child how to get their functional needs met.  We can do both – but this is extremely important and is overlooked by interventions that are not developmentally informed.

The full measure of joint attention is demonstrated by one partner’s awareness of another person’s attention, as demonstrated by taking active steps (joint attention bids) to manage the other person’s attention.  In a “joint attention frame,” I would notice or think of something and want to share that with you.  My attention is on what I notice or what I’m thinking about.  I now want to share my attention with yours, and yours with mine.  So I point it out to you in some way (I could point or gesture; I could say, “Hey look…” or “Listen to…”  [In other articles, we talk about reference points and how reference points and attention can involve any of our senses, and even our ideas - not just what we see]).

That wouldn’t be quite enough.  I have to be sure that we’re sharing what I intend for us to share.  So I check to see if you’re sharing: “Do you see that?” “Do you smell that garlic?”  I would probably look at you (gaze monitoring), or, if we were on the phone or not looking at each other – there are other ways:

Phone conversation…

Me: “Do you know Joe from the hardware store?”
Partner: “Joe with the red hair?”
Me: “No, Joe with the gray hair.  He’s very tall.”

In that transaction, I took an extra step to insure that we were referring to the real shared reference – not red-haired Joe, but tall, gray-haired Joe.  I might also check further by waiting or adding…

Me: “Joe – the Manager.”
Partner: “Oh yeah.  Joe Jones.”
Me: “Right, that’s him.”

Now we have a completely and accurately shared reference.

Sharing attention and building the foundations for the individual’s motivation to share their experience with the rest of us should be a major goal if not the major goal of intervention.

This is a defining characteristic of relationship-based therapies.  Other types of therapy may claim that relationships are important, but they have not studied or developed techniques to build the real foundations.  Being warm and playful is good, but that doesn’t make a method “relationship-based.”  Relationship-based methods focus on the foundations for intersubjectivity.  It is easy to do intervention without focusing on intersubjectivity, joint attention or true reciprocity much at all.  We can choose to focus on teaching a child to request things, or to speak in ever longer sentences, but if we are to make the person less autistic, we have to focus on the shared experience, and the capacities the child has and needs to be able to share their experience with others.  The examples below give some idea of how to help someone share experiences with others more fully.

Technique: Radical Lead Following

In Floortime, following the child’s lead means much more than simply using materials or subject matter the child is interested in in order to tap into the child’s motivation.  You seek to find the child’s current reference point and join in it assiduously.

More accurately, this involves joining the child in pursuit of her intentions and facilitating her accomplishing them.  This is in contrast with therapies such as Pivotal Response Therapy, or PRT, where the child-lead is a way of getting a child to make specific responses (e.g., utter vocabulary words; answer questions; imitate a response and/or other imperative demands).  Having said that, there is a great deal of overlap between Floortime and Pivotal Response.  Floortime, like other relationship-based therapies is a dynamical systems approach, where any type of response that continues the interaction is rewarded, whereas therapies in the behaviorist tradition of ABA are more likely to focus on getting the child to produce specific responses (e.g., to label something; to request an item).

Back to Floortime.  Good questions to ask at this point might be: How do I increase my child’s skills?  How do I teach her to communicate better?  How do I teach him self-help skills?

There are a couple of basic answers to those questions.  One is that you enter and then gradually expand the child’s currentsystem” (the system or frame that contains the child’s actions and intentions, and whatever objects or people that are also included).  Once you successfully enter the system, you want the child to welcome you in, rather than to resist you or to withdraw.  Therefore, you have to take a very calibrated step that will not destroy the system – but expand the system.

Another thing that you might do is introduce a problem for the child to solve on the way to attaining her goals.  You employ declarative techniques – comments, statements and observations, as well as actions that the child responds to, rather than getting them to follow directions, answer questions or respond in specific ways to a demand that you make (imperative techniques). You playfully get in the child’s way, or act as if you don’t know and therefore she has to find a way to get you to do something she wants, or you do something new that she might want to continue.  If you are attuned to the child’s intentions and staying within her developmental capacities – the child tries very hard to keep you engaged and to solve problems with you.  We’ll talk about what these “problems to solve” might look like in various ways and forms.

Finally, because of the need to develop specific skills that are needed right away – especially communication skills, there is a variation of Floortime developed by the ICDL called “Applied Floortime” that is almost indistinguishable from PRT.  (This just reiterates the point we make throughout this site and that is – it’s all ABA and eventually the autism wars will end and there will be more understanding and more rapprochement).

Technique: Radical Following of Interest and Intention

You always have to follow the child’s true intention, at least at the early stages (later on you might challenge the child and engage in the kind of co-regulatory tension expected in typical interaction outside of Floortime).  So if you pass a rose bush, you might think the most important thing is to talk about the color, the smell, the thorns or the other aspects of a rose that seem most relevant – to you.  But as you pass the rose bush, your child starts playing with the sand and the leaves around the bush.  You bend a rose over and you ask him to smell it – and he simply moves away and looks for more sand and leaves.  You ask him to look at the rose.  You exclaim about its beautiful red color.  He doesn’t even look.

Obviously, you and your child are operating in parallel universes.  It is doubtful he’s giving you the quality of attention and engagement required for learning, what Greenspan called “optimal engagement.”  Optimal engagement is powerful and you know it when you see it.  There’s a gleam in the child’s eye and he is very responsive and full of initiation.

You say to yourself, “The rose is not doing it.”  So you get down there in the sand and the leaves.  He’s picking up clumps of sand and pouring them through his fingers.  You start to comment, “Ooh, sand, leaves…”  No response.  You still haven’t successfully become a part of the play.  There’s no meaningful ‘back and forth.’  Your stuck (this is a normal feeling when you get started).  If you continue to comment, you see that he not only doesn’t listen or respond, he might continue to backpedal and move away from you.  You’re annoying him.

Finally, you cup your hands underneath his, so that when the sand pours from between his fingers, it falls into your hands.  He smiles.  You do it again.  You move to another position, but keep doing the same thing.  He moves to follow you – he wants to continue this new expanded system that now includes you in it.  You’re reciprocating – on a very basic level – but it is ongoing and dynamic.  You add something more: you begin to take your sand and pour it into his hand.  He squeals with delight.  You keep doing it – moving around, letting him pour the sand into your hands and pouring the sand back into his.  You notice that he’s now anticipating, by putting his hands out and waiting for you to do your part.

Once you’ve built up some momentum, you introduce a change that will spark some attention to you.  He pours the sand into yours and you just stop and wait.  You say, “Uh oh!”  He looks up at you – as if wondering – ‘what’s wrong, we had something good going?‘  You take that opportunity – where he’s looking at your face, to show excitement – and you throw the sand.  Now he’s cracking up – he loves it.  He brings you more sand.  You throw it.  He wants you to do this again and again.  You’re now engaging in those long chains of warm, emotional interaction they talk so much about in DIR, and there’s that gleam in his eye.

Now you scoop some sand and give it to him.  You can see that he’s stuck for a minute.  You can almost see the gears turning.  He’s thinking.  He’s still engaged, but he’s stuck.  You gave him a problem to solve.  He’s in a moment of uncertainty.  He doesn’t quite know what to do.  Then he throws it. He repaired the system.  Now you can go on this way.  You give him enough repetition so that each variation and reiteration of the system becomes comfortable before moving on.  He trusts and likes you in a new way now.  No one could ever join him in play the way he knows how.  Everyone just tells him what to do, but he never feels like this.  He’s never really wanted anyone – or more correctly, never experienced the unique joy that comes from sharing in this way.

Technique: Radical Following of Developmental Level of Play

Many readers may not know a child like this, or they may not see the real benefit behind it.  How does this help him talk?  He’s 4-years old already.  Who’s going to play with him like this?

Well, if you want to build one of the most important elements of social interaction – the desire to share an experience on a deep level with someone else – you will take the trouble.  Steven Gutstein of RDI calls these the “why bother?” skills.

Why bother?  Because otherwise, you take the risk of creating only the most rotely expressed, uninterested, reluctant and prompted forms of interaction.  You could still have success clowning and entertaining him, but he won’t be involved in any thinking or problem solving. Granted, some children on the spectrum start high, and they’ve mastered higher levels of relatedness.  But they are always missing some elements from the lower stages that preclude them from developing abstract and flexible thinking and perspective-taking.  They have trouble making inferences and drawing conclusions from different elements of a story.  We don’t go back to pouring sand with these children, but we recover these skills in more age-appropriate and meaningful ways that fit the child we have.

Once you build an intense desire to want to interact with others, you often see a ‘snowball’ effect.  More desire brings more interactions.  More interactions mean more variations, problems to solve, and more mental flexibility.  You see desire and persistence in the face of problems, whereas before, you had stagnation, withdrawal and avoidance of people.  Most importantly, you see a growing interest in others and more learning by watching others.  This leads to a lot of learning outside of therapy.  This is what Vygotsky referred to as acquiring the tools of learning, or what Robert and Lynn Koegel of Pivotal Response call “pivotal responses.”

When working with a DIR professional – you talk about where you can take this – because the point is to elicit as much problem solving as you can in a session.  This develops new skills, and you want to grow in complexity.  Eventually, you will be able to spot opportunities to do this in the course of everyday routines – you’re no longer completely reliant upon taking time out of your schedule to do Floortime sessions.

I realize that this is an example that many might not be able to relate to, because their child might be further along the developmental ladder – well beyond simple sensory play.

So let’s introduce DINOSAUR-LEGO-POKEMAN KID!!!

Most of us professionals have met him – several dozen times.  He’s pretty smart.  He can tell you everything you never wanted to know about his favorite subjects, yet he has little or no interest in anything anyone else is interested in.  You can easily engage with him in conversations about his favorite subject(s).  But despite his adequate verbal abilities and his probably above-average ability to remember facts, he still has real trouble truly relating to others, and as he gets older, he’s at risk for more punishing forms of social isolation, teasing and maybe bullying.

Different methods have different ways of dealing with this.  RDI would not want to feed this beast, so they would encourage more active engagement in the here-and-now of the current context; what the Guide or partner is doing, or what they could do together that is new and different.  After all, a serious problem is that there is no real reciprocity going on.  The kid isn’t really interested in your contributions,.  It’s a one-way street.  There are traditional ABA methods that would also ‘put this on extinction’ – in other words – stop encouraging it – stop responding to it.

But here, we’re talking about how a Floortime partner might deal with this.  A Floortime partner would use the same principles – joining, getting chains going, expanding the system and introducing problems to solve.  So here’s the dialogue:

Kid: “A T-Rex could probably crush a car in his mouth.”
Apropos of nothing, he brings up his favorite subject.  The Floortime partner takes the opportunity.

FP: “You think so?”
(This is a question, but it isn’t as imperative as other questions could be, like “What kind of car?”  When on their favorite subjects though, verbal, less impacted kids can tolerate more imperatives – but you don’t want your half of the conversation being exclusively questions – that’s not really joining).

Kid: “Yeah!”
(He’s encouraged to keep going with the mild imperative – it didn’t throw him off as imperatives often do).
“Even big cars.”

FP: “Even giant animals!”
Pivots on “bigness.” Joins and adds a variation, joins on the emotional level of excitement, but gently steers him towards the possibility of talking about things relevant today.

Kid: “Yeah.  He ate mostly other dinosaurs.”
Back to dinosaurs.

FP: “And people!”
A problem – because people don’t factor into his encyclopedic conversation about dinosaurs and dinosaur movies.  But it’s productive uncertainty because it isn’t that far out of his ‘box.’

Kid: “There were no people back then.  Dinosaurs are animals, but there were no human beings.  It was 65 million years ago, so there were no people then.”

FP: “I think Dad was there.”
Playful, still steering towards the here and now.

Kid: “He’s not that old.”
Note that we’re now talking about Dad.

FP: “Dad’s only about 2 million years old.”
Joking, playful productive uncertainty.

Kid: [Laughs] “No he’s not!  He’s like 60 or something.” (He’s 32).

FP: “He’s older than me.”
Joking, playful productive uncertainty.

Kid: “No he’s not.  You have gray hair and my Dad has black hair.”
We have now bridged into a conversation about us.  We’re fully in the here and now and there’s no more dinosaurs.  This could launch aq new system – curiosity about people’s ages.  This has the potential for being annoying for sure – but it is a focus on people – real people.

FP: “Oh you know how to tell.  I’ll bet you know how old everyone is.”

This may seem daunting – for the Floortime partner to have so much skill exercised so flexibly.  But if we remove the commentary, the conversation goes like this…

Kid: “A T-Rex could probably crush a car in his mouth.”
FP: “You think so?
Kid
: “Yeah!”
FP
: “Even giant animals!”
Kid
: “Yeah.  He ate mostly other dinosaurs.”
FP
: “And people!”
Kid
: “There were no people back then.  Dinosaurs are animals, but there were no human beings.  It was 65 million years ago, so there were no people then.”
FP
: “I think Dad was there.”
Kid
: “He’s not that old.”
FP
: “Dad’s only about 2 million years old.”
Kid
: [Laughs] “No he’s not!  He’s like 60 or something.” (He’s 32).
FP
: “He’s older than me.”
Kid
: “No he’s not.  You have gray hair and my Dad has black hair.”
FP: “Oh you know how to tell.  I’ll bet you know how old everyone is.”

We don’t need to go further with this example, but we’ve had so many conversations like this that we know that we can keep circles going for a very long time – all with very impressive levels of engagement, thinking, warmth and humor, puzzlement (productive uncertainty) and bridging from topic to topic.

Also note in both of the examples above, that at first you follow the child’s klead, but before long – the lead exchanges more normally.  You’re neither exclusively following or leading.

The main point here is that you have to enter at the child’s level of interest, thinking, and capacity.  Too far outside this zone and you will end up with the kid not wanting to continue talking to you (withdrawal), or a rigid responding, where everything you try to say or do snaps back to dinosaurs.  That isn’t useful either.

Individual Differences

Individual differences have to do with the apparent neurological and developmental obstacles to learning, communicating and relating.  This comes from close and careful examination of the child, knowledge of neurological processing issues and their telltale signs, and collaboration with other professionals.

At SCS, we have a strong emphasis on something called “motor planning.” A motor plan is the pathway from “ideation” (the formation of an intention or a response to stimuli) to “praxis” (Greek for “movement”).  Motor planning is basically thinking and moving and involves the following elements in a Motor Plan Analysis:

  • A source of idea or intention (ideation)
    • Attention changes from one thing to another
      • This can be a novel, spontaneous or creative idea or intention
      • This can be a response to a stimulus inside the body (e.g., hunger, pain, restlessness, the desire to seek or continue a pleasurable state, etc.), or something that occurs outside the body – an event that the person notices
      • This can be a response to a stimulus that a person may or may not be aware of, but that somehow triggers an idea from memory
    • Attention focuses on the new stimulus or change in stimulus and sensory perceptual mechanisms tune in or prepare for input (tuning).  If tuning does not prepare prior to the switching of attention, reflexive or unprepared or haphazard responding is probable, possibly even begun by a startle.  This is why carefully monitoring your own speed is an important way of facilitating full benefit in any method you use.In ongoing, truly engaged interaction, where there are no overwhelming surprises, this can run quite smoothly.  But this attention switch is very difficult to achieve when the person is doing something else that is not engaged with you.
    • Attention and Memory interchange.  This is very technical, but the evidence shows that attention and memory are versions of the same thing.  Memories aren’t stored anywhere.  Memory is how attention reignites neural pathways that represent prior experience.  Conscious awareness is the process of activating these circuits in the moment (current experience), whereas memory is the process of activating the same circuits at a later time.  Very often, a cue in the environment activates a memory and turns into an idea that requires attention to the moment.
  • Perception (Input) and Movement (Output) happen simultaneously (the Perception/Action cycle) when the brain is working well and is “in sync.”  They constantly update each other for smooth functioning:
    • Perception (this has to do with the process of initial uptake of sensory information to appraisal of the meaning of it).  Here, we want to assess how the child:
      • Evidence of how he or she experiences the sensation or basic sensory awareness of the internal and external world.  We may not be able to observe the brain’s function directly, but there are characteristic behaviors that demonstrate how a child compensates [or fails to compensate] for difficulties in input processing.  We also are able to interpret the results of psychological and sensory testing better than others because of our depth in developmental and educational psychology.
        • Some children under-register sensory stimuli.  They are less sensitive or impervious to sources of sensation that others would normally notice or feel.  We can see their compensations as sensory-seeking behaviors.  That is, they seek to intensify their experience by behaving in ways that increase their ability to feel or experience sensation.
        • Other children tend to “over-register” sensory information.  They tend to engage in sensory avoiding behaviors such as covering their ears when they hear an intense sound.
      • Evidence of changes in arousal before and after changes in the environment or in ideation.  Arousal has to do not only with the ability to sense and perceive information, but also to become interested and emotionally engaged enough to focus their attention on a stimulus.
        • Under-aroused children have trouble getting interested in the world and staying focused enough to learn.  They form few reference points at all.  They have a passive posture towards the world and can be apathetic.  They can be daydreamers.
        • Over-aroused children can be disorganized and scattered and can ‘go too fast’ to really discover meaningful reference points.  They can be impulsive and distractible, or
          • they can become hyperfocused and operate like ballistic missiles once they form an intention (trying to stop them or change their course can enrage them or further increase their rigidity).
      • Evidence of comprehension. Comprehension has to to do with how the mind makes meaningof the hundreds and thousands of data points surrounding the individual within and outside the body.  Sensation doesn’t always lead to perception, and perception doesn’t always lead to conception or comprehension.A lizard feels something and reacts.  That’s going from mere sensation to action.  Perception is the awarenessof the source and type of sensation.  It is a mental representation that can be remembered.Comprehension has to do with the ability to make meaning of patterns and regularities and change in the world.  In this respect, we look at:
        • Whether the person is able to understand the meaning of spatial arrangementsof objects or people.  Does the child comprehend that there is a line forming at the slide, or does he walk right up to the front?  Can he tell from watching a basketball game who is on which side, even though they are constantly moving around?  Can he tell from how close or far apart people are standing, or the postures they take – what the mood of the group is?
        • Whether the person is able to understand the meaning of sequences of events or actions and the like in order to form a “gestalt” (an appreciation that the whole is greater than the sum of its parts).  The importance of gestalt thinking is too deep of a subject to go into fully here, but it is integral in understanding the difficulties with abstract thinking that many with learning and developmental disorders such as autism experience.This is especially true when it comes to behavioral gestalts.  These have to do with how steps are tied together into a singular action melody.  A child has to learn that the behavioral gestalt or action melody of “Mom getting me a drink” involves a series of steps.  Mom doesn’t just produce the drink like a magician.  She doesn’t even approach you at first.  She first goes to the refrigerator, gets the pitcher, goes to the cabinet, gets a cup, pours, etc.  All of these are connected into a singular behavior gestalt or behavior melody of “getting me a drink.”Understanding behavioral gestalts helps us understand other people’s intentions are – the directionality of their actions.  And that makes us feel safer because we can see the orderliness and direction of the actions and plan our movements in anticipation.  The ability to understand such patterns helps us see the regularities of the environment in what otherwise might seem chaotic.  The difficulties with this are manifest in the lack of tracking (continuous monitoring and focusing on changes and progressions of actions) that we see in autistic disorders.  We can readily observe the absence of tracking behaviors.   An we can correlate, as has been done empirically many times, the the compensatory behaviors:  resistance to change; insistence on a static and predictable world – a preference for sameness.
    • Attention: Attention is motor action seeking input.  We can see a person’s eyes move as a sign of shifting attention.  But every sensory apparatus moves or “tunes” in a physical way, usually involving some form of movement.  The mechanisms inside the ear move like little radar dishes.  The head and/or body turns; nostrils open; saliva readies for taste, etc.  We look at the following aspects of attention that are necessary for motor planning and coninuous, smooth perception and action:
      • Attention release: this has to do with how smoothly and easily the individual releases their attention from the current focus.
      • Attention search: this has to do with scanning the environment for reference point, or the memory of relevant reference points
      • Attention focus: this has to do with finding, selecting and settling attention on reference points
      • Attention maintenance: this has to do with keeping the mind on the same reference point long enough
      • Attention following: this has to do with “tracking” and “monitoring” changes in reference points in order to find patterns, anticipate, and discover the directionality or intentions of other people’s behavior or the behavior of an object
    • Movement: This is fairly straightforward – or so it seems.  Movement involves how the brain coordinates physical action and thought.  We can see obvious overt signs of clumsiness and difficulties with coordinating physical action.  In most cases of developmental disorder, there is some awkwardness or dyscoordination of movement.  But this isn’t always obvious or always the case (it is rare though: almost all cases of developmental or attachment disorders, bipolar disorders and schizophrenia in children show concomitant dysfunctions of praxis).   We judge the quality of movement by its flexibility and ability to adapt quickly to changes in input. 
      • Movement is dependent on constant updating from perception.  As we move through the world, our position in relevance to the things around us changes.  This is how we avoid obstacles and adapt our movement as the position of our body changes vis-a-vis the objects we hold or encounter.  We make adjustments as to the weight and feel of objects.  We make adjustments to the movement patterns of objects.  Movement should be a two way street.
      • Autism is a severe learning disability when it comes to the processing point of analysis.  All learning disabilities involve some issues with the smooth coherence between different brain circuitry that control the multicomponent and multivariate aspects of perception, attention/memory, and movement at all levels.
        • Autism is considered the outward behavioral and developmental manifestation of an underlying disorder of central coherence.  Connectivity between the interdependent circuitry of the mind is affected, causing bottlenecks in the flow of information.  This results in the characteristic:
          • looping behaviors (repetitive and circular behaviors such as hand-flapping or pacing; looping of thoughts such as perseverative interests and difficulties getting their minds off of things);
          • interruptions in train of thought (getting lost in the middle of trying to carry out steps and forgetting what one was doing), or
          • the opposite, not being able to stop what one intends to do or to be able to change course in the face of changing circumstances (what we call a “ballistic motor plan“).  This accounts with the so-called high co-incidence with OCD or Obsessive Compulsive Disorder.  OCD involves an obsession or fear (e.g., of germs) that can only be assuaged temporarily with a specific repetitive behavior tied to it (e.g., washing hands).  Personally, unless there is a clear and distinct difference fear (obsession) tied with the repetitive behaviors, I consider it to be looping and not OCD. But it is not our place to argue with a diagnosis from a competent Neurologist or Psychiatrist.  We’re interventionists.  We don’t really focus on diagnosis.  We look at development and behavior independent of diagnosis.
      • Thought is movement without overt actionThought is internalized movement.  Whenever you think inside your head, your mental representations are almost always visual clips.  Think of going to the grocery store.  What do you “see” inside your head?  You see yourself moving through the store, scanning the environment, doing things.  You don’t just see a static picture, and, while you might hear language inside your head, the language merely narrates the image-ination going on inside your head.

These are just some of the individual differences that DIR considers.  Therapy would then focus on recruiting stronger channels and circuits to help repair or exercise weaker ones and help them learn.  In our initial Functional Analysis of Behavior, we do a “motor plan analysis” where we look at behavior in terms of affect diathesis, taking it apart via the individual differences we can readily observe above.  We look at the patterns of relating, communicating and problem solving, and how the individual goes about it.  In traditional Functional Analysis of Behavior, we look at the consequences that behavior produces.  But the consequence a behavior produces may not be intentional – it may not be the intention of the person behaving.  Besides the consequences, we want to look at the very important antecedent conditions that involve individual differences in neurological processing.

Floortime Techniques Associated with the ‘I’ or Individual Differences of DIR

Technique: Attunement

Attunement is the process of trying to assess the subjective state of another person on a deep level.  Babies and people with disorders of relating and communicating cannot share in an effective way what they feel or think.  They have difficulty comprehending or appreciating what we feel or think.

The Floortime partner is highly attuned.  They constantly assess the child’s moment-to-moment intentions, feelings and actions. Granted, these are mental states and the process of attunement is fraught with error.  But attunement, is what makes us human, and it is a characteristic of our genetic endowment to be able to learn how to do this.  Furthermore, we learned because someone else was able to teach us.

In other sections on this site, we refer to Tronick’s Mutual Regulation Model, and how the process moves from synchronous relating (when partners are in tune with each other and interaction flows smoothly), to the inevitable breakdown (there is some misunderstanding or disagreement were some new information that is not yet understood by one or both partners) and the all-important efforts to repair the system (what partners do to get back “in sync” and continue the interaction).

Tronick’s Mutual Regulation Model sequence:

  • Synchronous relating
  • Inevitable breakdown (minor to major)
  • Repair

All of which lead to increased…

  • Competence in relating and repairing, and subsequent…
  • Resilience

From this perspective, “breakdown” is considered necessary for interaction to be dynamic, spontaneous, and interesting.  In a Floortime interaction, naturally the Floortime partner is more capable and takes more responsibility for making the repairs of the breakdowns.  However, breakdowns produce moments of uncertainty that are opportunities for learning.  So it is better for the Floortime partner to assume only enough responsibility and to allow or even introduce therapeutic breakdowns so that there is this uncertainty, and the child has to “try things” in order to resolve the uncertainty. This promotes the child to look for relevant reference points into invent behaviors or call upon previously learned ones in order to resolve the uncertainty and bring the interaction back in sync.  Tronick’s Mutual Regulation Model, which comes from the field of Infant Mental Health, has made an important and seminal contribution to our understanding of how we learn social skills. The role of the more capable Guide or Floortime partner then, is to make sure – by being attuned, that these moments of uncertainty are not overwhelming and remain “productive” in the sense that the child can resolve the uncertainty with reasonable effort. This is why it is so important to understand the child’s true capacities – developmentally, and from moment to moment.

Attunement may seem inconsistent with the principles and philosophy of behaviorism and ABA. However, we make assessments based solely on patterns of overt behavior. That is the only way that anyone can do it – be attuned.

Scaffolding

Scaffolding means supporting the individual in some form of Guided Participation teaching.  The word was coined by a disciple of Lev Vygotsky named Jerome Bruner and is the developmental discipline’s version of behavioral techniques of modeling, shaping responses, prompting and fading.  But there is an an important nuancal difference.

Scaffolding bypasses a lot of time spent in developing readiness skills.  for instance, there would be no point in teaching a child to sit at a table and learn the labels of “grass” “lawnmower” “handle” to learn how to mow a lawn.  Instead, in a Guided Participation teaching frame the Guide and the individual would simply go out and mow the lawn.  The Guide would assign appropriate roles to himself and to the Learner. Along with these roles come designated role actions that but Guide assigns. Naturally, the Guide would reserve the more complex role and role actions for himself and give portions of the task that are within the Learner’s current capability and zone of proximal development (that set of skills that the Learner can perform either with help or with more practice).  As the Learner becomes more adept, the Guide “transfers responsibility” gradually to the Learner. The “help” that the Guide gives along the way changes dynamically along with the growth of the Learner’s skills. Guided Participation teaching is sometimes referred to as the, “Master/Apprentice Relationship.”

All of the above comes from Vygotsky’s model of learning, which like Greenspan and Gutstein, emphasizes the social and emotional relationship between the or capable partner and the Learner. The term “scaffolding,” comes from the Vygotskian tradition, but it is equally applicable to Floortime.

“Scaffolding” is an apt term, because just as the painter does not lower the building in order to paint the top of it, neither does the Guide or the Floortime partner lower the bar for learning.  Instead, the painter builds a scaffold so that he can reach the top. When the top is painted, he lowers the scaffold so that he can move downward and finish painting the building. The analogy here is that the more capable partner provides support during a meaningful and context-based activity with an authentic product. There is no decontextualized teaching. There is no wasted time developing unrelated “readiness” skills.

In the terms of the ABA, natural environment teaching uses scaffolding but they may use a different jargon. In a Guided Participation teaching approach, the initial phase may involve explicit modeling and teaching and gradual lowering of the scaffold, which in ABA terms would include strategies of “modeling;” “most-to-least prompting” and; “prompt fading.”  Once the Learner begins to perform the skill, the Teacher would exercise a “least-to-most” prompting strategy – providing help only when needed and providing as little help as possible so that the Learner demonstrates maximal levels of independence.  Now there are many differences that we can identify between techniques used in Guided Participation teaching or a traditional behaviorist teaching format – none of which I want to go into here. But there are a lot of essentials that are the same.

In Floortime of course, we are following the child’s lead. The “meaning” and “authentic product” that we work with is the child’s intention. Nevertheless, the Floortime partner, being the more capable one, provides scaffolding in order to help the child achieve her intention.  In addition, as in Guided Participation teaching, the Floortime partner provides a good deal of scaffolding so that the individual with deficits in communicating and relating can engage in reciprocity and put to use their full potential Functional Emotional Developmental capacities.

The following is a compendium of scaffolding techniques that can be appropriate for use in Floortime:

Technique: Slowing Down

The first technique involves giving the child plenty of time and space to respond. This is one form of slowing down. We always keep in mind the central coherence disorder that is the neurological deficit causing the autistic symptoms and the problems with motor planning, so we have to be slow in the way we pour in the “input” and patient in how we wait for the child to formulate a response (output).

Now we have talked about the child that is perhaps chronically underaroused and subsequently needs the Floortime partner to quicken the pace in order to “energize up” the child, but this does not mean an absence of slowing down. In this particular case, slowing down would involve limiting the differences in the variations in the type of inputs we present to the child. We keep in mind that this type of child has difficulty forming systems and discovering patterns, so we simplify patterns so that he may join us, or more correctly, we turn what he does into something that we can do together.

Apart from the above example, slowing down is more straightforward.  Here we will give a non-exhaustive list of examples of slowing down that can be used in Floortime:

  • Slow down your communication.   Slow down your speaking and provide more than adequate space between your words. We might take for granted that the typical infant has an innate ability to find within a string of syllables the beginnings and endings of words. But when we think of our experience listening to a language that we are not familiar with, we cannot do this. So especially in the case where the individual differences include auditory processing issues and language delays, speaking slowly and providing a lot of space between words becomes an especially important plank in the scaffold;
  • Over-articulate your words to emphasize the component phonemes.  This is also an important plank in the scaffold that helps the Learner with auditory processing issues to more fully comprehend speech.
  • Slow down your movement. You want to move at a speed that maintains interest and fun, but you do not want to move so fast that the patterns of your movement become isolated from each other and the child cannot infer continuity between your actions (i.e., a behavioral gestalt). If you are moving all over the place, the child cannot detect a pattern and cannot anticipate your actions. Move deliberately.
  • Slow down your affective expression.  The human face is a very complicated stimulus because it is almost always moving. If the Learner has difficulty understanding the different configurations of facial muscles involved in affective, emotional displays, then he will have even more difficulty if you are rapidly changing your expressions. You want to hold your expressions a little bit longer so that the Learner can appreciate them before moving on.

Technique: Simplifying

Taking care of the individual differences of the Learner means relating at a proper level of complexity so that absorption and comprehension are maximized. You certainly don’t want to do too much too fast and overwhelm the Learner. Here is another non-exhaustive list of ways that you can reduce complexity:

  • Use controlled levels of structure and stimuli
    • Choice of Materials: The choice of materials that you leave in the play area will often determine where the child’s interest and attention goes.   This is why “baiting” the area with toys you want him to explore is a good idea.
      • Limiting access to too many toys or distractions will help the child remain organized and focused and allow for more repetition.
    • Set up areas where certain types of activities take place (e.g., blocks; representative toys; sensory materials, etc.) and bins with similar types of materials in them.  “Areas” carry with them certain expectations that help the Learner “shift mental set.” That is how our minds work to anticipate and prepare responses so that we can be more quick and flexible. Within each area, there are characteristic materials and expectations for behavior. The Learner experiences a lower level of anxiety because in a given area he or she can anticipate what will happen more easily. It is Less effective to use one part of the room to do everything. In clinical or classroom settings, it is not uncommon to use the same floor space for physical play, play with representational toys, play with construction type toys, art activities, eating, and everything else. This makes the Learner more dependent on prompting and can be confusing. Contrast this with the way a home works: people usually eat in a certain area, play in another, work in another, etc. (granted, these lines are often blurred in modern life – but neurotypical children don’t have the same kinds of problems shifting mental sets that children with system forming disorders have).
    • Use Bins as a source of controlled vocabulary and content.  Bins really help you keep yourself and the child organized.  Bins help with shifting mental sets because the bin provides for some homogeneity and boundaries for activities. Just as an area that contains certain types of materials and has a tradition of certain types of play and behaviors associated with it, a bin can provide some or a similar level of scaffold for categorization and pattern recognition. Also, when you load the bin, you know what’s in it and you know what vocabulary is possible. This will help you with data keeping.
    • Stay within the Learner’s zone of proximal development.  This means controlling the level and type of variations that you introduce. You have to be very careful with us and learn to appreciate the child’s true intentions as described above.

Technique: Intensifying

Individuals with autism have difficulty noticing and tracking what goes on around them. They can remain captured by their own actions and ideas and be somewhat or totally oblivious to what’s going on around them.  Floortime is a method of getting into that world and enhancing and growing it.  But you can hardly be effective if the child does not notice you. You want to become an important part of the play, not just a mere facilitator. A mere facilitator is like a coin-operated machine. While it may be useful to observe the child lining up trains and then become a part of the play by handing the child the next train – this is a beginning step. Before long, you want to take noticeable actions so that you challenge the child – you intentionally break the synchrony as in the Mutual Regulation Model, so that the child has to develop a new skill in order to repair the system.

Here is an example: The child is currently engaging in a well-worn activity of lining up trains in exactly the same way. You sat and watched this for a while and learned the pattern.  The next time, you get between the trains and the child and you become “the Giver.”  This can be a very important demonstration to the child that you not only understand what he’s doing, but that you appreciated and you have no intention of taking over or taking it away from him. Granted, the play is monotonous and stagnant and you eventually seek to change that, but this is your starting point.

Eventually you want to do something noticeable and to break the system. So perhaps you hand him the right train, and then another right train, and then another right train, and you keep going in this manner, and then you hand him the wrong train intentionally. You have an intense little moment here of uncertainty. You play dumb. Now the child has to work in order to get you to give him the right train. He wants to fix the system badly. You don’t allow the child to simply reach across you. To make it easier, you hold up the right train and the wrong train, but you keep them both out of reach. He reaches for the train that he wants, and you treat that as if he pointed to the train. In later iterations of this pattern, reaching can beget a prototypical point gesture, which can be get tapping, which can be get pointing and so on.

Technique: Intensive Responding

Respond to Non-communicative Acts as if they are Communicative

As in the example given above you respond to non-communicative acts (i.e. burps, sneezes, actions, etc.) as if they are communicative.  In the example above the child attempt to reach was “shaped” into a more articulate pointing gesture.Some individuals that are functioning at Stage II or below (the child with the trains appears to be functioning at about this level), may not understand basic “contingency.” That is, they may have difficulty understanding the effect their behavior has on others and/or what others expect them to do when they direct an action towards them. Now the child with the trains in the example above may be able to function in many ways contingently in familiar situations where he has experienced them by rote and has learned what to do and what is expected. But his parents might tell you that when it comes to new situations, they almost always are difficult and they feel like they are starting from scratch.By responding to unintentional communication and using those behaviors to “shape” more intentional behavior, you are teaching contingency and setting the foundations for truly reciprocal “two-way communication.”

Narrate and Comment, But be Careful

Comment on things (“Bubbles!”) with limited vocabulary and repetition (below).  This refers to the use of declarative language and declarative actions as a means of enticing the child to interact with you without pressuring her to perform specific responses. In other articles on this site, we talk about declarative forms of stimulating responding. What we will say here is that by slowing down and waiting for the moment when you have the child’s mindful attention, that may be a good time to associate a word with an object or an action. It is “intense” when the Floortime partner carefully waits for that moment and assiduously takes opportunities.

This particular point needs more attention. Talking while your child is doing something can be distracting and even annoying and ultimately ineffective or counterproductive. There is no point in talking when your child is not listening. You want to wait for that moment when you really feel that your child can take in what you say.

Verbose commentary is absolutely out of the question.  Keep in mind that processing multiple streams of information is one of the secondary deficit of the central coherence disorder that causes autism. While on the one hand you want to be able to help your child form associations between words and objects and actions, on the other hand, you want to make sure that your child understands the connection. There is always this potential for “mis-mapping” your words to the wrong object or action, so you have to be careful.  For instance, while observing your child drink juice, you can say “juice” or “drinking juice,” but the atypically developing language learner can easily misunderstand what you are referring to.  As you say “juice,” the child may not understand whether you are referring to the liquid, the cup, the act of drinking, or the fact that you were sitting there talking. This is not a problem with typically developing children because they have developed a system for observing and figuring this all out.  This is why they don’t go through a very long period where they confuse the words “I,” “You” and “Me.”  Typically developing children learn most of the words that they know from overhearing conversations between other people and connecting that to the directions of people’s eyes, attention, and subsequent actions. Children with language delays and disorders of relating and communicating have not learned to learn this way, so there is great potential for confusion when you are sitting there narrating.

Intensively share the child’s space

Get down to the child’s level, physically and euphemistically.  Get on the floor if that makes sense.  In another article on, we talk about zones of “connection;” “efficacious intent;” and other references to the proper distance and proximity required to get consistent responding and ongoing circles of interaction. We talk about how the zones are dynamic (how they change according to the child’s interest and engagement from moment to moment and; how in one instance you may be too close and crowding and in another instance too far away and outside of the child’s field of attention).  The space is right when you feel an intense sense of connectedness with the child.

Adults turn children off by

  • Giving too many directions
  • Asking too many questions
  • Placing too much emphasis on responding, following directions, finishing, cleaning up, etc.  In other words, too much emphasis on performance – or the child’s ability or willingness to please you.  This is being too “imperative.”
  • Insisting that there is a right way of doing things. Now perhaps joining the child in chewing on the furniture is a little bit too “radical following of the child’s lead.” That could be turned into a game of “do it again,” where you dare the child to chew on the furniture [do it] again and each time he tries to do it you tickle him.  This ends up with very little chewing on the furniture and a lot of reciprocal back and forth play.But there are a lot of things that children on the spectrum do that are odd or even inappropriate. The four-year-old who get pleasure out of dumping over the toy box is certainly in need of improvement, but you have to start there.  Perhaps you can gather up the materials once she dumps them onto the floor and fill up the box with just a few things and then hand the box back to her so that she can dump it again. But then, you can take the empty box and pretend that it’s a hat.  She might want to imitate that, and once she begins to use the box as an item of apparel, it now has more than one use and we have the very rudimentary foundations of abstract thinking. We can build quite a bit on this humble start.
  • Directing the child’s attention to what you think is important. You will often lose the child in the process and end up directing and correcting, which is what every conventional teacher does.   Floortime, can be very useful when such approaches have not been effective or that have created a defensive and anxious child when around adults.  We gave  examples of that with the child and the rosebush and DINOSAUR-LEGO-POKEMAN KID above.

Language Techniques

Maintaining and Improving Responses

Shaping Responses/Reinforcing Responses: The Discreet Trial in Floortime

This is an interesting comparison.  But as you can see in the examples we’ve given, Floortime interaction is a series of contingencies and contingent responses.  Each one of them can be mapped out as a trial where one of the partners provides a stimulus or cue for the other partner, that partner responds with an action, and the partner that opened the circle (provided the stimulus) responds in a way that provides for another circle of interaction. Just like in an ABA discreet trial, there is a chance for failure and breakdown and corrective feedback. It’s done a little differently in floor time, but there are the same kinds of contingent responding that include the intensity and the basis in behavioral shaping that constitute the evidence basis for the use of the technique. As I have mentioned in other articles here, the evidence basis for a lot of the newer ABA packages do not come from full-blown randomized controlled trials, but from the use of very well tested techniques of behavioral shaping used in Floortime.

Know What Truly Reinforces a Behavior

The brain as a self-regulatory apparatus: Positive feelings are the true reinforcers – these are the experiences the brain in programmed to seek out and repeat.  All of the techniques that we think are effective and evidence-based utilized some manner of associating stimuli that is already reinforcing with more enduring forms of motivation such as the feelings of satisfaction that come from mastering something (Tronick’s “resilience;” the feelings that come from finally understanding and knowing how to fit into a pattern that lead to feelings and desires for increased confidence and self-efficacy). Mastery is the reinforcer.

If we can engineer environments and relationships so that we can arrange for mastery experiences associated with us, then the Learner will give us increasing license to introduce new things and new patterns and new experiences more frequently.  We find that this type of therapeutic experience generalizes a lot faster than anything we might seek to produce by putting a child in the position to perform for artificial reinforcers.

Further, children that form such rigid systems and that may be quite intelligent at the same time can be extremely perfectionistic as part of their profile of autism, so conventional “social reinforcers” can actually be counterproductive.  Instead, it is better for the child to develop an ability to derive feelings of satisfaction based on self appraisal and not become dependent on the praise and appraisal of others in order to know whether or not something is good or to continue.

Set Yourself Up for Success

You want to set up the environment so that you both can be successful.  You want things available that are interesting but that are not isolating or difficult to share.

Freedom from worry – freedom to explore

The first thing you want to do is to set up a safe area that is somewhat constricted in terms of space. On the one hand, you want the child to be free to explore and to be able to touch anything – you don’t want to be saying, “No” very much. So it is not a very good idea to play around delicate things in your living room, audiovisual equipment and wires, sharp things, etc.  This will help you be more relaxed as well.

Too much space can be a problem, especially for the child that has difficulty forming intentions and wanders around a lot, or for the child that backpedals and avoids. If you are working in a very large space you might consider rearranging furniture so that you can set up barriers and make it smaller. These barriers can also be sources of fun, for instance, when the child tries to climb over the couch or under a table – you can join us and make chasing or tickling games out of it, and in the meantime you are slowing the child down and making it not quite so easy to escape the demands of relating.

Eliminate the Competition

One of the secrets in Floortime or Guided Participation teaching or any other relationship-based technique is for you to become the most interesting thing in the room.  Ideally, your face should be the most interesting thing in the room from the most commonly referenced source of information.

You want to keep in mind that there are certain objects and certain types of toys, that because of the individual differences a person might have, have not only become favorites or preferences, they have become almost exclusive sources of entertainment. Things like spinning wheels, electronic toys that can be managed simply with the push of a button, puzzles, etc., are simply too easy and can be extremely attractive and compete for your attention.

Advice to control this competition may seem contradictory to advice to follow the child’s lead. We just know that there are certain types of toys and competition that interfere with any method that you might use it if you can get rid of them or do without them, you are probably better off.

Electronics: Electronics are notorious for being difficult to share. So in your Floortime area, you might want to get rid of hand-held video games, computers, or even push-button toys because there isn’t a whole lot that you can really do with them. Turn off the television.  We put this little bit of advice in the “Individual Differences” section because people on the spectrum are particularly vulnerable to becoming “captured” by these types of toys or activities and they have even more difficulty sharing them. The more captured that they become, not only is it more difficult to share, it is more difficult to get them to make a transition away from the toy – so you’re better off without them.

Pepper the Area

On the other hand, you want to cover the area with objects that you know your child finds interesting.  This can be a tricky value judgment on your part. On the one hand, you might think that materials like sand or leaves or a piece of string that your child likes to twirl might be a bad idea because it has been so difficult to share that with her in the past. But then on the other hand, she might really appreciate you sharing this with her and by doing so, she can “feel felt,” that is, someone finally comes along and instead of taking it away from her and treating it as a stupid activity, her play partner becomes one of the first people to finally “get it.” We recommend that you use these objects, although they can be difficult to share.

Construction materials (Legos, Blocks, Lincoln Logs, Tinker Toys, Magnetix, etc.) might also seem difficult to share, but they are among the best types of materials.The value judgment that you made here has to do with how static the goal of the play is. Nowadays, too many toys come in kits where there is only one way to complete the project. Back in the day for instance, like those used to come as a collection of assorted pieces that you can make anything with. Now it’s hard to find just the blocks – everything is part of a kit to make a “Star Wars” fighter or an aircraft carrier or whatever, and now, the intention comes not from the child’s imagination but from the picture on the box and the instructions. Such a toy can be useful at the earlier stages of DIR, when you simply seek to join an activity and you are not that worried about working on imagination. But when you are working on imagination you want to have neutral materials that can be used in dynamic ways.

Then there is always the ubiquitous train set, in particular “Thomas the Tank Engine” and his friends. The “Thomas Stage” has almost become a stage of development, particularly for boys – lots of children really glom onto this toy. “Thomas” has become an industry of its own, replete with videos, movies, all kinds of connected characters, placemats, underwear, and I’m not kidding – Thomas the Tank chopsticks! For a child prone to develop excessive interests, Thomas can be a perfect fit and a ready supplier.

All joking aside, Thomas is fine. If you are wondering why kids with autism seem to be particularly attracted to Thomas, you might want to look at one of his videos.  Thomas’s face is pretty static – it changes once per scene. And the characters are pretty wooden – they don’t move very much. This eliminates a lot of the challenge of pattern discovery, motion tracking and other aspects of behavioral gestalt thinking that are so challenging for children on the spectrum.

Some girls can be into dolls, but girls on the spectrum often play with dolls statically. That is, they dress the dolls which is like completing a puzzle. They tend to do it in the same way every time. Once the doll is complete, they are satisfied and they don’t do anything else with it. These too are fine.

Neutral objects such as balls, Frisbees, or sports equipment that “pull” for interaction would be great – if only your child were interested in using them with someone else. If that is the case by all means put some of those in the area as well.

There are books out there that can tell you how to set up a play room, but those lists work really well with neurotypical children or clinics that see a lot of different kinds of children. You don’t need all that. All you need is what you know your child is interested in and to try to keep out the stuff that just pushes you away like electronics. If your kid likes to twirl leaves, put leaves in the area.  Remember, you put things out there that your child can easily find interesting and will give you a lead, not what you want your child to play with and that he won’t touch without you taking the lead.

Brothers and Sisters and other more capable Players

Sometimes that more capable brother or sister can be an asset, and sometimes they can be too dominant and interfere. Think about it – here you are giving your child exclusive attention and having a lot of fun, while your other more capable child is supposed to sit on the sidelines and understand why you’re doing this. Most of you out there will not need me to explain to you why this can be a problem. First of all, every child wants their own personal clown! Secondly, typically developing children always want to show you how good they are at things. If you are involved child has difficulty making a block tower, his brother or sister will want to show you how they can make one all the way to the ceiling. And they will talk, talk, talk, and be very busy and fast and possibly overwhelming to their brother or sister on the spectrum.

Do we shun this child? Do we expect a three or four or five-year-old sibling to somehow understand why you can’t pay any attention to her right now? Good luck with that.

There are a few things you can do depending on your situation. While it is hard to get a younger sibling to slow down in order to be comprehensible to your child on the spectrum, you can try by giving him or her some specific role to play. The role allows him to show you what they can do without barging in on your attempts to slow down for your impacted child.

If you have help, especially from your spouse, that might make an excellent time for them to spend some “Special Time” with the siblings so that you can focus on a much more simple dyad. It is hard enough for a child who is just beginning to learn to relate and to discover the patterns of other people’s behavior in a slowed down and simplified dyadic interaction with a very attuned Floortime player. Siblings over the age of 18 months or so are remarkably complex if they are developing typically and they can be overwhelming to your child on the spectrum. You cannot expect them to sit on the sidelines for very long – they are going to want to join. You can give them privileges that they normally would not enjoy – such as extra time with electronics or videos, but you may be uncomfortable with doing that. Special Time can be just what the doctor ordered (see the article on “Special Time” and how to make that work really well).

Floortime Techniques Associated with the ‘R’ or Relationship Aspects of DIR

Technique: Intention Facilitation

Intention facilitation is a key technique, especially when establishing a new relationship with a child, or when dealing with a defensive or very sensitive child.  A major Floortime mistake is to be overly intrusive and take over the intentionality of the interaction. The assumption here is that children that are fully prepared to co-regulate at age expected levels don’t really need an intensive intervention like DIR.  Individuals with serious processing differences and challenges have difficulty with flexible adaptation to new information or change.  They have difficulty forming motor plans and staying on them.  They compensate for this difficulty by giving up easily and withdrawing, or reacting defensively and in a controlling way and trying to coerce the world into remaining the same or following along with the child’s own rigid motor plan.  These children will need some kind of specialized intervention.  Here we are talking about DIR, and the way to help them with Floortime.

Intention Facilitation works like this:

  • The Floortime partner watches the child in action for a while, before attempting to do anything or to enter the child’s play.  He or she will notice two broad types of individuals:
    • Individuals that have difficulty forming intentions in the first place. These children appear to be aimless and apathetic. They wander and they don’t really form any systems of interaction between themselves and objects or other people. They often engage in looped and repetitive behaviors focused on their own bodies, or very repetitive actions on objects that are characterized by an extreme lack of variation.  These children often interact with objects in a purely sensory way – not really using them in the way the object is intended to to be used (e.g., shaking and banging a toy truck were putting it in her mouth or throwing it; repeatedly emptying drawers and spilling the contents on the floor; knocking things off shelves, etc.).  Arnold Miller, developer of the systems based “Miller Method” refers to these children as having a “system-forming disorder.”
    • Individuals that tend to form closed systems. As Miller states, “… [they are] so preoccupied with one or more objects that they totally ignore people, and have difficulty with transitions. Left of themselves, such children may spend hours lining up blocks or twin animals were flushing toilets, or opening and closing doors. Some become very distressed of the usual way of going from one place to another is altered.” (Miller, 2007)  At the lower or “more impacted” end of this spectrum, are the children that create the simple tableaux and that can become very disturbed by your efforts to introduce variation. At the upper and or “no less impacted” end of the spectrum, are those individuals that may be involved in many different kinds of systems including social ones, but that have difficulty incorporating new information coming from people. They may be able to have conversations – such as the “dinosaur kid” mentioned above, but they can go on and on without really “taking up” the perspectives and contributions and variations coming from others.
  • The Floortime partner then figures out how to fit in.  With the aimless child that has a “system forming disorder,” the Floortime partner tries to turn the absence of the system into a system that the child can comprehend. A key part of this would be becoming part of that system and sharing reference points with the child. Specific techniques about dealing with this type of child are outlined below.With the more rigid type – the one that Arnold Miller might refer to as having a “closed system disorder,” the Floortime partner observes the tableau or the directionality of the child’s intention and seeks to be a useful helper at first. This is the only way that such a child might let you in. She will not let you in by simply taking over, making suggestions, or adding variations – sometimes even in the smallest degree. Specific techniques about dealing with this type of child are also outlined below.

Goal: “Going for the Gleam in the Eye”

Stanley Greenspan talked a lot about the types of arousal that represent ‘optimal states for learning.’ He base this on findings from neuroscientific research and common sense if you will, that people focus more productive attention on things that they are interested in.  When things are interesting to them, it is not hard for them to focus on them, and it is not hard for them to maintain their focus and persistence.  It is also a neuroscientific fact, that the quality of the attention that comes from interest is most suited for learning. Contrast this with attention that is “coerced” by offering incentives or threats on objects or subjects that would normally be an interesting to the child. Unfortunately, the motivation for children to pay attention and to “demonstrate learning,” is to merely get adults to leave them alone. This is compounded by the offering of rewards that are enjoyed alone (e.g., the awarding of break time where the child spends it in solitary play, time on the computer, or worse, “time to stim.”

If you have been lucky enough to have engaged a child in a highly intensive, emotional (hopefully joyful, but this may also include intensive negative feelings focused on you), you know that “gleam in the eye” when you see it.  This type of interaction involves frequent incidences of “positive anticipation,” those moments where the child continues to focus on you as he or she waits excitedly for you to continue. A very easy example would be a tickle game, where the adult tickles the child and then pauses for a moment, and you can see that the child is strictly focused on the adult and excited about what is going to happen next. This is a very obvious moment of “positive anticipation.” Another obvious example might be when a child expects a surprise that the adult holds behind her back. You might see that the child squeals and jumps up and down and is completely and totally involved emotionally. Contrast this with other activities where the child seems to be merely complying and going through actions perfunctorily in order to obtain an unrelated reward.

Evidence: Circles of Interaction

As mentioned many times throughout this article, DIR focuses on increasing the individual’s ability to engage in long chains of ongoing, continuously reciprocal, spontaneous and warm social interaction.  Greenspan came up with a way of measuring this – not in simple terms of duration, but in the number and type and quality of back and forth actions, especially those on the part of the child.

A “circle of interaction” is really more like a triangle. It starts with one member of the interaction “opening the circle” by engaging in an action intentionally directed at the social interaction partner.  This action could be as simple as a gesture such as a look in that person’s direction, a smile directed at the person, handing the person something, saying something, etc.  To qualify as an opening of the circle (or for that matter any aspect or part of a circle of interaction), the action must have some sort of communicative intent directed at the partner. We will talk about how to get that to happen with a technique of ‘responding to unintentional behaviors as if they were intentional communications.’

The next part of the circle involves the other partner responding to that opening with a congruent and equally intentional response.  Here again, the response could consist of any of the forms mentioned above, more or less, with the qualification remaining that it has to be an intentional act related to the prior action of the partner.

The circle is closed when the “opening partner” responds to the response.  That is, the opening partner responds in a congruent way to the partner’s response to their opening response. One of the primary goals of the a Floortime session is to engage the child in interactions of as many consecutive circles as possible. A good metaphor for this would be a game of volleyball, where reciprocity represents continuous bouncing of the ball back and forth from one team to the other, where no one drops the ball.

The experienced Floortimer learns from the dropped balls. They are inevitable. One reason for this inevitability is that it is human to experience breaks in interaction. But a more relevant reason is that we are dealing with individuals whose primary presentation and reason for referral has to do with their difficulty in engaging in ongoing spontaneous social interaction.

Technique: Enticing instead of Leading

It is comparatively easy to tell a child what to say or do, or to rehearse “scripts” and responses that the child learns to emit given a certain cue.  The problem with this is that in dynamic and spontaneous social interaction is almost impossible to anticipate every possible cue.  Not only that, we’ve all had the experience of trying to rehearse a conversation to ourselves and to anticipate what our partner might say or do.  We inevitably find out that within a minute or two, we are off the script and on our own.

One of the distinguishing characteristics of good Floortime is the almost complete absence of the adult directing or prompting the child to do anything. The emphasis is almost completely on child volition. The Floortime partner is a very excepting person indeed. He or she is prepared to respond to almost any type of action the child might make. There are no incorrect responses. There are only responses to shape into reciprocal interaction. This could include joining a child that is engaged in totally self-focused actions that have no intentional communicative meaning for others. In many cases, the circular and repetitive behaviors don’t even really represent “play.” They may simply represent efforts on the part of the child to achieve or maintain some sort of neurological homeostasis. In some cases – perhaps many, such circular, repetitive or looped behaviors produce opiates and induce very pleasurable “trance-like” states.  Any attempt on our part can represent a serious “buzz-kill” for the child. He or she does not want to stop. He or she is not in distress and is not stuck.  He or she is having a really good time and does not need other people.  It can be very difficult indeed to try to enter this sort of a system.  One must use creative ways in order to enter such a system, but there are ways in Floortime technique that emanate from the principles of DIR, and some earlier research on the social induction effects of imitating the child’s behavior rather than the other way around.

Goal: Having Fun without Entertaining

It can also be comparatively easy to entertain a child.  Novice Floortime partners can be fooled to thinking that a ‘gleam in the child’s eye’ is leading to some form of learning.  Here, we have a very strong connection to the “behavioral” aspect of ABA.  That is, learning can only be demonstrated by an overt demonstration of a skill by the Learner.  It is simply not enough for a child to enjoy watching you. It is not enough for the child to enjoy being a passive recipient of your actions. The child must be an active responder.

As in ABA, Floortime works from a system of goals and objectives that operationally defined the behaviors that represent learning.  ABA allows for the child or the Learner to demonstrate any number of behaviors that belong to a class of appropriate responses. There is no necessity to evoke a very specific response. What we are looking for is a congruent response that represents intentional behavior on the part of the child and that serves to facilitate continued interaction. The goals and objectives set forth by the Floortime partner will come from a DIR assessment and follow the conceptually systematic hierarchy or epistemology of the DIR method.  This epistemology is based on thousands of studies that demonstrate typical courses of development and the need for foundational skills to be mastered before higher skills can be demonstrated convincingly. There is no provision in any ABA manifesto that the order noted in typical child development cannot serve as a curriculum basis – although in reality, many of the curricula that you see in practice in ABA does not appear to be informed by neurobiological development and neurotypical epistemology.

Technique: Be Playful

This has become a given in almost all aspects of early intervention.  We realize that a young child’s primary mode of learning is through play.  Didactic forms of learning are not ethologically natural for our species, and this is especially true for children.  Modern humanity has been around for at least 1500 centuries, where as didactic teaching has only been around for a few centuries. Schools and school settings such as classrooms teachers up in the front teaching and children sitting at their desks receiving instruction is very new on this timescale. It has proven effective in many ways, but there are perhaps more ways in which it is ineffective. If such a manner of teaching were effective for children with disorders of relating and communicating, we certainly wouldn’t be having this discussion.

Play is one of the “developmental tasks” to master in childhood – to be elaborated upon further throughout the lifespan.  In other words, we play throughout our life in one way or another and we continue to learn about play each time we do it.  One of the best things you can do is to watch the child for a while and see how the child plays.  There are several broad categories that are relevant: how the child plays alone with or without objects; how the child plays around people or with people; how the child handles boredom, and; what makes the child laugh or enjoy things? After all, you are looking for a “handle” that you can grab so that you can enter the child’s play in the joyful and reinforcing way.

One of the bigger challenges is the child that doesn’t seem to really play. They may engage in wandering or jumping, but there doesn’t seem to be any point or any room for another person in the play. These children are obviously having difficulty forming systems, and the Floortime player would some how try to make a system out of apparently “system-less” play.

In general, tickling, jumping, and sometimes run and chase games are available to young children and the “emotional young” child, but not every child likes to be touched. This type of “puppy like” play usually works with young children. Sometimes, the aimless wanderer can be gathered up in a game of “I’m gonna get you.”  An excellent source of ideas for ways to be playful – even for the avoidant or disinterested wanderer can be found in a book called “Giggle Time” by Susan Aud Sonders, which we list in our bibliography.

Another possibility is to try to engage the child in very simple games that you play with babies. These might be as simple as touching the child’s nose playfully and making a sound effect, playing pat-a-cake, or peekaboo. You can also turn unintentional behaviors into big, playful effects. If the child bumps into you can fall over playfully. She might turn around and want to do that again. If she is sitting on the couch, you can take her feet in your hands, and naturally she will push a little bit, in which case you can fall over backwards to make a big deal out of it. When she then raises her feet, you are now getting circles going.

Floortime can be used in the context of ordinary routines where it doesn’t really seem to make sense that the child would be in the lead, such as when dressing or bathing or cleaning up. Playful surprise is a key technique that you can use here. For instance, as you are rolling up the sock and he’s putting out his foot, you can then put it on his hand.  You can turn bath time into a game of peekaboo by getting down on the floor and pop in your head up over the rim, or, you can play games of “bombs away” by dropping different things into the tub.

Questions that we are often asked have to do with whether or not a parent should always have to be playful; whether there is a danger in creating an expectation of playfulness and every routine, or; how will the child know when it is time to be serious? The answer has to do with making the changes in your behavior noticeable enough, for instance, your playful tone and your matter of fact tone should be able to show a clear changing of gear. But not every child is sensitive to that, and once lured into the pleasures of playing, children are wont to give it up.  In such a case there are other options available.

You can use what we call, “gear changers.”  Popping in a short song (or singing a song), allowing a short video, serving a snack, and similar things can really settle a hyper-excited child down in a minute.

Sometimes, the problem is the opposite – the child is two under-aroused and turns out to be a rather limp play partner. These children have difficulty waking up their nervous systems and need little bit of help. Sometimes they appreciate a little bit of deep massage first or some bouncing on a ball or a bed, or some tickling. This is what they call in Floortime, “energizing the child up.” The point we’re making here is that arousal has a lot to do with play – and so does trust.

Challenge the Child

It’s clear by now the floor time is not near play – it is a teaching technique. It is meant to foster development and it works according to clear goals and objectives for growth. Therefore it is necessary to provide challenges for the child during the Floortime play.  Let’s go back for a moment and look at the basic problem – affect diathesis.  The person has difficulty forming an intention and/or bringing the necessary perceptual, conceptual, social, emotional and physical skills to bear in order to accomplish it.

For the child that has difficulty forming intentions in the first place, what Arnold Miller refers to as a “Systems Forming Disorder,” the challenge is to learn to form an intention. So let’s say that the child wanders around the room aimlessly moving from one corner to another or from one object to another without really doing anything with it, or engages in endlessly looping behaviors such as hand flapping or jumping.  In such a case, you challenge the child by taking essentially what is unintentional and turning it into an intention. We go into this a little bit further below, but basically, you have to provide some sort of “playful obstruction.” In the spirit of treating unintentional behavior as if it were intentional, by getting in the way of someone who is pacing, they now have a problem to solve of getting around you or over you. In other words, they have to form an intention to get around you. We will repeat this particular caution many times: you want to do this in as playful a manner as possible and your goal is not to continuously frustrate the child or make yourself annoying. We are trying to attract rather than repel.

The Unintentional Child

The easiest child to work with is one who is alert and oriented to the present, and is able to focus his attention on something for at least a minute or two.  However, child’s willingness to play, or her ability to engage in optimal play learning can be quite variable, especially if a lack of play skill is the main problem.

Some kids wander aimlessly much of the time.  They simply are not always interested in toys or people.  Some kids can become interested if given something to do, or if invited or tempted by something interesting.  And with some kids, their stage of play development is still infantile and largely self-stimulatory, and their wandering may simply be the only way they know how to explore their environment.  Pacing and wandering maybe just ways to dissipate energy and pass the time.  Others do it mainly when they feel stressed or bored.

The first thing you have to do is to get the child to notice you.  You have to do something that the child must form a response to.  The point is that you are challenging the child to do something different.  It is not within the scope of this article to tell you everything that you can do (we don’t even know and never will – the possibilities are endless), but in general they tend to include variations of:

What to do with Wanderers
  • Use temptations (declarative actions with or without toys [e.g., funny noises; falling down; throwing a blanket over his head...] that usually spark interest) and seductions (e.g., singing a song, or doing something in front of the child that might draw him in such as blowing up a balloon).
  • Limit the playroom to only a few things that are likely to be very interesting.  Don’t try to compete with toys or activities that promote aimless behavior (i.e. TV).
  • Use interruption techniques (last resort) such as putting obstacles in the way, “stop games,” piggyback rides, throwing a blanket over her and playing “peek-a-boo,” etc.   These games can be frustrating and off-putting to a child, so be careful and sensitive.
    • Playful obstruction” (e.g., if the child is crawling you get in his way and he crawls over you and you wrap them up in roll him over and then let him go; getting in front of her and gently guiding her through your legs and becoming a playful “spanking” machine… So what you are really doing is you are now turning the wandering into kind of a steeplechase);
    • Hyper- or Intensive Responding” (as in the example of the child bumping into you and you fall over backwards;  which introduces a contingency or a cause and effect into what was before behavior without much of a cause);
    • Turning wandering into a game of chase or ‘hide and seek’ (e.g., playfully “chasing” the child and turning it into a game of “I’m gonna get you” and tickling him or pulling him to the floor for  a game of roly-poly when you catch him; getting in front of her and popping out from behind furniture – this could now create a level of vigilance which is a more active state of arousal and problem-solving than you had before, etc.);
    • Mutual Imitation: Some children respond to your imitating them. If he notices it, stops and looks for a moment, and then the next time he does it he looks at you, you are starting to see him do the behavior on purpose.  Now the “intention” is to get you to imitate him, or at least observed the effect for his cause. In a lot of cases, you can then turn the tables and start adding variations that the child imitates. When that happens you really have the potential for a lot of circles of communication going back and forth.
What to do with Observers

Observers like to sit and watch.  They’re either very shy, environmentally sensitive, or slow to warm up.  They also may have difficulties with rapid motor planning and imitation.

  • My Turn, Your Turn.”  Do something interesting and very easy like bounce on a ball or knock a block tower over and then invite the child to do it by saying “My Turn” when you do it and then motioning for the child to come over and say, “Your Turn” and then, gently encouraging participation.  If the child still shows reluctance, don’t push. Sometimes a child make take a long time to really process what she sees. There will be many times where you’ll do something one day and you won’t see the child try to imitate or participate, and then when the child is on her own time – you might see her doing it!  This is especially true for children who have difficulty with motor processing. They have way more difficulty figuring out how to make their body move than you might think.  So it can take up to a day for them to figure out how to “motor it out.”  Sometimes, the neural integration can only occur during sleep.
  • Insert your face between the child and the object of interest.  Work on gaze shifting and attention sharing by looking into the child’s eyes, then to the object, and back and forth.  This is a matter of tightening up the “Joint Attention Triangle.”Most of the time, children are short and grown-ups are tall – in comparison. Grown-ups’ eyes are up here, and childrens’ eyes are down there.  And people in general would rather look slightly downward than upward – which is why we experience eyestrain when we work at the computer for too long.So it is a good idea to position yourself in general slightly below the child’s eyes. You do this by getting on the floor or getting on a knee. This is true even and especially when the child is seated in a chair. The best position when a child is sitting in a chair is to be at a 45° angle and slightly below the child’s eyes. Maybe it is because Floortime players get down so low all the time (as do Preschool Teachers that know what they’re doing) that that is the reason it is called Floortime. Oh, as a matter of fact, that is the reason it is called Floortime.
What to do with “Loopers” 

More than likely, a “loop” is just a very short motor plan that consists of one step that is repeated over and over.

At around the age of eight months, as a child learns to “imitate herself,” so you see children repeating very simple actions on objects such as reaching and putting them in their mouths, and more relevant to the discussion here, shaking and banging objects.  This often goes with the delightful behavior of pushing things off surfaces like highchairs and watching them fall to the floor, which they can do over and over with endless delight (beginning cause and effect).

Some children on the spectrum do things like turn the light switch on and off over and over again or open and close doors repeatedly or they do some of the exact things that you see a nine-month-old babies do like bang a spoon the table.  They often do the same thing with many different objects or all objects.  These children are showing you the stage (Developmental) or cusp (Behaviorist) of exploration they are currently in.  Let’s call it a “style” or a “means of exploration” that your child uses as primary.  Whatever the explanation is, when the behavior seems to be a form of play, here are some things that you can do:

  • Expand the System: Let’s say that the child turns the light on and off. This might be the progression that you introduce:Child turns on the light
    Child turns off the light
    Child turns on the light
    You hold your hand out for “high five”
    Child high-fives you
    Child turns off the light
    Do that several timesChild turns on the light
    Child high-fives you
    You turn around as if you’re doing the Hokey-Pokey and then hold out your hand for another high-five
    Child high-fives you
    You turn around again and then hold out your hand for another high-fives and you hope that this time the child can do the turning around part too
    And so forth and so on until the child forgets about the light and you are off doing other things
  • Switch Objects: Capitalize on the child’s means of exploration and delight in repeating a behavior by rotating the objects in which she does this.So what you can do is to fill a basket with the kinds of objects that you know he likes to shake and bang or spin or twirl or whatever, and as he gets ready to do it again give him another one of the objects. So you become kind of like a jukebox.  You can add some excitement to this by working with the objects in a concealed container and revealing them ever so slowly to note that excitement and positive anticipation. This kid is going to want to continue doing Floortime with you because he knows that you know what’s really cool, and you’ve got a stuff.  By slowing down and “milking it” to maximize that positive anticipation, you are no longer a coin-operated jukebox, but a fun human being.Keep doing this for a while, taking one really cool object out of the bag after another, and then take something out of the bag that you know he doesn’t want. At that moment you were creating this little moment of uncertainty where he is likely to look at you, and then you can in an exaggerated manner shake your head and say, “Nooooo.”  Now cast it aside, and then motion as if you’re asking whether or not you should reach in the bag again.  Wait for that “look,” of approval or anticipation and then keep going, randomly interspersing good and bad objects. This will keep his attention on both you and what comes out of the bag rather than just on the bag.
Looping as a Means of Inducing a Trance-like State

Looping behaviors can produce a very pleasurable state the child does not want to give up.  In any case you want to become a part of this “system.”  These children can actually produce a “trance-like” high by engaging in repetitive behavior. We know this because there have been studies that show that repetitive behaviors produce pleasant neurochemicals such as serotonin, dopamine and oxytocin; we see that people under extreme stress resort to primitive self soothing behaviors such as rocking back and forth, and; we also see that monks and other people that intentionally induce themselves into altered states of mind use repetitive chanting or thoughts.

If this is your child, other people and even professionals will disagree on whether your child “needs to do it” or that “he needs to stop it.”  The answer to that question can be different for every child, which is why we call it an individual difference. I would try to settle the question by asking us to agree that if we could somehow or another rewire the brain through teaching (all teaching and subsequent learning rewires the brain to one extent or another), we would want to help the individual “not need to do it;” to have something equally pleasurable and useful to replace it.

In Floortime, we want the child to behave voluntarily.  This might involve switching from the behavior to something else, or varying the behavior and varying it more and more until the original behavior is no longer recognizable.

Because these repetitive behaviors often travel dopamine pathways, there is an addictive quality to them. They are hard to give up. They are pleasurable. Our intrusion into them can be experienced as an extreme “buzz kill,” or like asking the alcoholic to put down the bottle. If this is the case we want to tread carefully here – again, we want any behavior change to the volitional or voluntary. That motor plan has to be connected to an idea that comes from inside the child’s mind and not ours.

Here are some things you can do:

  • Focus on Arousal: Since this appears to be an arousal issue, then it makes sense to focus on meeting her needs for arousal with an equally pleasurable type of interaction.
    • Functionally Equivalent Sensory Replacement: Look for things that you can do that belong to the same “sensory channel.” Most of the time these behaviors are in the proprioceptive channel. So encouraging activities such as climbing and jumping and bouncing on the other things can meet the same need.Also consider that children who have poor vestibular development can be preoccupied with behaviors directed at their own bodies such as jumping or patting their chest, so engaging them in movement, especially climbing where there are challenges such as in ladders and going under and over things can not only be therapeutic, but also the source of interaction by playing follow the leader. You want to include lots of belly crawling, somersaults, climbing up the slide and things like that as challenges to their vestibular and motor systems.
    • Massage: Deep pressure can be relaxing and stimulating at the same time, and this might almost be able to compete with the buzz they get from trance-inducing.
  • Mutual Imitation, as described above;
  • Declarative Actions, as described above. This may not work because it is really hard to compete with “getting high.”
  • Expanding the System, as described above.
The Rigid, Inflexible Child

There are so many ways for a child to be inflexible that it would be impossible to cover them all here.  But there are a few common types and we can give you some suggestions for them:

The Visual Tableau Child

This is the child of lines things up; it sets a very rigid visual tableaux of objects that if you try to move or alter them will spark rage or something just short of it.  They will line up or place their objects in a very particular way and go on that way for months before you ever see any sort of variation, and if you do see variation, it has to be their idea. They can leave the room and if you move one of the objects ever so slightly, it will be the first thing that he notices when he walks back in and he will fix it. This is what Arnold Miller describes as the child with a “Closed-System Disorder.” In systems theory, a closed system resists new information entering the system. This is exactly what you have here. “Repair” to this child means returning the system to exactly the way it was, not something new (as the way “Repair” works in Tronick’s Mutual Regulation Model, which is all about “open” or dynamical systems).

Entering the Visual Tableau: When beginning to do floor time with this type of a child, the last thing you want to do is barge in and change a lot of things. In fact, you’re better off not really changing anything except who gives her the next piece.  The silver lining in this is that regularity. What you do, is you sit by and watch the creation of this tableau and you make note of which order and which part goes next.  Once you have the “assembly instructions” memorized, you can think about entering.

First, you might have to wait until the child puts it away or takes a break, because you want the materials to be on your side behind you. If she can simply reach over and grab materials there is no need for you and you might as well not be there. So the first thing you do is you get between the materials and the child and her tableau. She’s going to think you’re pretty cool if you seem to know what goes next. This is the move least likely to upset her. Just as in the “switching objects” scheme described above, you go along with the regularity of the system, handing her the objects that she expects, and then eventually, perhaps after some trust has been built, you start playfully handing her the wrong ones.

Now watch out! Don’t do this too soon. She would rather you not be there because she was doing just fine before you tried to enter her play.  Take your time.

You probably have seen additions to this tableau periodically, but it may be next to impossible to figure out how she decides what to add. Usually, she notices some other object lying around and takes an interest in it or she sees something on television or whatever and then she spontaneously just decides to add it.

Problems with Parts-to-Whole Perception:  It is key that you understand the individual difference(s) going on here. First of all, it is very likely that this child has difficulty discriminating parts from the whole. If you change one little part, then she may actually have trouble recognizing the whole. This is because her focus tends to be either too much on the individual parts without seeing the whole, or on the whole without seeing the parts. This child’s mind takes photographs that resist Photoshopping.  She’s not going to let you switch anything or substitute one part for another, that simply won’t work.

Baby Steps” is the key. Whatever you add should not be radically different, such as putting animals on top of the the trains or rearranging the dolls in different positions. You might try just adding something similar to the end. So if you have a line of trains you might consider adding another train at the end, or you you have a child that just dresses the doll in the same way, you might consider adding an accessory.

This might seem like it would take forever to bring about any kind of change.  But actually, what you are working on as a functional emotional developmental capacity is tolerance for change, and as you build up a track record of change, then more changes become easier and larger steps possible.

Same-way Sadie

Same-way Sadie has to do everything the same way every single time. Once she experiences something, it appears that she has an internal belief that it cannot change – so routines get set in concrete very quickly. If you go to a new store, then she is going to want to go the same way every single time. If you read her three stories, she is going to want you to read them in the same order in the same way every single time.

Same-way Sadie has very much in common with the child described directly above, for the same reasons. She has difficulty with part-to-whole or “gestalt” thinking. One of the most important functions of the prefrontal cortex is to be able to hold things in memory buffers, sort of as a mental chalkboard, so that we can rearrange things inside our head before we have to actually do them. This skill helps us anticipate the consequences of making changes before we do them.  This child has difficulty doing that and tends to use other parts of the brain that are better at memorizing for long-term memory – to function in the here and now. The problem with that is that the here and now is a dynamical system and long-term memory is somewhat of a closed system. They don’t match, so this child comes off as rigid when she tries to operate almost exclusively from long-term memory. In other words, if we take a trip to the store, on an emotional level, we understand that it is just a way to get there and that there are other ways that might even be better. The emotional part of this is that we accept that. But we have to be able to do the prefrontal thinking in order to get to that emotional stance. It is almost a chicken and egg thing. You have to have the prefrontal wiring, and you can’t get the prefrontal wiring without exposing yourself to change. This child needs change more than anything in the world, but it is likely that she has developed defensive behaviors or even aggressive behaviors to keep people from trying to change things on her. It is a vicious cycle.

Baby steps is one way of dealing with this – small changes. But I think it’s important to point out here that this will cause some discomfort and that is okay. As long as you’re not trying to change every system at once. One thing to do, is to start out with systems that she doesn’t seem to be very emotionally invested in if you can find them. There may be some things that she actually doesn’t care all that much about and you can start by changing those regularly.  And you progress towards changing systems where she cares more – in baby steps.

Social Stories: Social Stories are short stories that you compose to help the child expect change. They are the ultimate in static thinking, but they can be useful as a bridge towards change – a temporary, but beneficial compensation if you will, but definitely not a tool that you want to use for all manner of changes that you might introduce. You don’t want to use any sort of visual schedule or visual support or Social Story as a primary means of learning to deal with change, because this merely reinforces the child’s worldview that the world has to match the picture. Sure, many people; many professionals will argue that with the use of visual supports you can change the parts by adding changes to the schedule regularly.  That may be a useful trick, but it is still very static and it doesn’t really teach dynamic thinking.  The world is a movie not a picture. The world is an ever-changing story, not a printed text.  When you over rely on these static interventions, you teach the wrong reference points. The reference points should be the changes that are actually going on in the environment, which include how people feel from moment to moment. That is impossible to depict in a Social Story or any other form of artificial reference point. Ultimately we want to teach the child to switch attention, track and monitor, rather than consult prefixed instructions or schedules.

With that caution in mind, you can go ahead and use Social Stories as temporary bridges.

Video Modeling:  This is a variation on the visual support theme, but with moving parts. You take video clips of behaviors or situations that you want the child to enter, and the changes they are to expect are depicted on the video. I have the same criticism of this, although it is better, because it is also pretty static in nature and does not teach real tools of dynamic thinking. It does however give the child more time to sit with the new situation and to have some control over it and to change his emotional threshold.

But don’t confuse Social Stories and Video Modeling with learning how to cope with ongoing, spontaneous, long chain social interaction in a dynamical system. It is better to work in the here and now and to take baby steps and to go very slowly so that the child uses you as a reference point and later on, the rest of the objects in the outside world as reference points. A big problem with Social Stories and Video Modeling is that we are again bringing the dynamic world in a static form on a silver platter to a person that really needs to learn the tools of dynamic intelligence.

The “Scripter”

Scripting can have different functions or uses for the child. The same child can use scripts for different reasons, and use just a few scripts for many reasons.

Scripting shares a lot with visual tableaux. Scripting represents difficulties with part-to-whole thinking and flexible interchanging of the parts to make new wholes.  We hardly ever say things the same way each time. That is because we use parts of our brain that specialize in recombining elements to perform novel actions and word combinations. When one uses, or over relies on long-term memory, what you get are chunks of memory that are not interchangeable and that are projected as indivisible wholes.

Functional Scripting: This child uses a “best match” strategy to find something he has learned and committed to long term memory for the situation in the here and now.  The scripts that he uses sound pretty close, but they are inflexible in that they are usually worded in exactly the same way every single time (they are not grammatically recursive as natural language), but they are pretty close to the context at hand.

Functional Scripters want to have conversations, but they make errors and they sound repetitive because they rely on their long-term memory rather than on the parts of the brain that are meant to recombine smaller pieces. These are two distinctly different pathways in the brain, and what they need is more experience using the dynamic pathways.

With Functional Scripters, you do a version of system expansion by adding to the script or recasting the script with slightly different words.  It is very important that you do not shut these scripts down because this is all the child has to carry on a conversation and really wants to be included. When a parent shuts a child down by saying “No Movie talk,” she may be shutting down the child’s ability to contribute anything at all. This is what the child has, and if you shut it down you have nothing to build upon. If you shut it down and try to replace it with something unrelated or a brand-new sentence, it is going to go to long-term memory and it’s going to come back to you as another script. Simply compiling more scripts will not make the person any more fluid or any less autistic. Everything will still sound rote, taught, and well, scripted.

Scripting as Play: Notice that I do not use the term “self-stimulatory” in these articles. That is because we all stimulate ourselves through play and other things that we do alone, it is just the low rate of variance that gives it the term “self-stimulatory” in our field. If I read a book or listen to an opera I am self-stimulating.  If I read the same book over and over or listen to the same opera over and over, some might label that as “self-stimulatory.” The repetitiveness makes it no less “self-stimulatory” than anything that I might do that has variation and novelty to it.

Behaviorists have come up with a better term, perhaps for this reason and it is called “automatic reinforcement.” These are the things we do to make ourselves happy by ourselves. We would do them whether or not anyone else was with us – but most of us tend to do these things when we are by ourselves. When we do them in the presence of other people without seeming to acknowledge that fact, then it is a behavior that stigmatizes us and is in need of change.

Some people like to utter things as a way of entertaining themselves. This has a different function but we don’t call it “functional scripting,” I guess because it has no real intention for communication. Speaking should have some intention for communication, even if it is just for ourselves (e.g., such as when we think aloud). When scripts are used as play, the person does not direct the speech at anyone else and is just as likely to do it when by himself as he is when around other people. So in this way the script resembles the visual tableau, and can be I think rightly referred to as and auditory tableau. Therefore, the intervention would be the same. You would take the same steps that you would when dealing with a visual tableau. That is, you would enter gently and start expanding the system using the language technique of recasting.  I keep trying to link you to the article on recasting, because it is a very useful technique used by a lot of different language interventionists, and for our purposes here let’s just suffice to say that it is a way of expanding a verbal utterance. It is a means of systems expansion that you can use for both the Functional Scripter and the Scripter that uses scripts as personal entertainment.

The Avoider

The Avoider avoids for a reason. Often this reason is because so much in the life of an individual with autism is misunderstood. What we may see as unusual or inappropriate behavior may be very important to the child nonetheless.

It is interesting to note here that one of the fundamental contributions of Behavioral Science, is the Law of Determinism, which posits that all behavior happens for a reason. Just because we do not understand the reason at the moment, does not mean that it is purposeless or not adaptive.

One of the most beautiful things about Floortime, is that it is unequaled in its ability to show a person respect. So much of what we do is intrusive. We look at that odd behavior and we seek to change it. We look at that visual tableau as malfunction in play, and we often discount it or try to take over. We recognize that fitting into the world means following other people’s lead and doing things that are consistent with what typical people do.  Indeed, it is hard to argue with all of the above. Floortime is about change.

But, Floortime looks at the behavior and tries to figure out what it means to the person.  Floortime recognizes that what seems useless, “non-functional” or whatever pejorative we care to place on what this individual does – is this person’s way of being in the world. That line of trains, those spinning objects, that peculiar pattern of actions strung together in that odd way – well it just may make no bit of sense to us, but to that person it can be their Mona Lisa.  In this way, the Floortime partner can establish the type of intimacy that the individual may never have experienced before.

The key to dealing with a backpedaler is to be “attuned.” Attunement recognizes that change is necessary, but at the same time recognizes that individuals do not seek to be changed. It is so easy to dismiss the odd behaviors as unnecessary and to simply take over.  Professionals may find it easy to just toss out the advice, “just throw out the dinosaurs.” Sometimes I wish I could empower the individual to counter, “OK, you go first. Throw out your wedding pictures and your license and the deed to your house, and then I will consider throwing out my dinosaurs!”

On the other hand I think it is a gross misunderstanding of DIR to assume that stringent following of the child’s lead is anything but a place to start. Soon enough, regular challenge will be an integral part of the sessions. At the end of the session, both parties should be spent. The Floortime partner is exhausted from the intense level of attunement and responsiveness, and the individual will be exhausted from having to do so much thinking and problem solving to continue the fun.  It is understandable that a child can be somewhat “fried” after a session and need some downtime. That is a sign of a good session.

The Floortime partner shows attunement by backing off and being responsive to the child’s back off signals. But the Floortime partner doesn’t respond to failures and breakdowns by going away.  The Floortime partner is persistent.  The Floortime partner studies his mistakes and learns from them. Yes, breakdowns will occur – the child will abandon play or backpedal or complain or try to isolate – these are indeed signs of some type of failure. But this is no reason to go away. Friends don’t go away and neither do loved ones over simple failures. There is breakdown and repair. Sometimes it might take a while and sometimes it might be a struggle.

The Jane Goodall Approach: You may recall the famous Primatologist, Jane Goodall.  She is famous for being accepted into a band of wild chimpanzees and becoming a part of their family. A very crucial part of the story is that her initial efforts were seriously rebuffed. Even when she tried to offer them food, they reacted fearfully, hostilely, and sometimes with defensive and anxious aggression towards her.

But she was very attuned. She responded exquisitely to their back off signals and they learned not to fear her. She had to sit and watch them almost motionless for almost a year before they made their initial approach toward her. She allow them to take the lead. She had to. Chimpanzees are so physically strong that they’re capable of tearing a human being apart.  But they never hurt her.  That is because she never pushed them too fast or too hard. But eventually, she had become so well accepted into the chimpanzee family that she was allowed to handle the infants and to assert herself quite a bit. They allowed her to take the lead just like any other member of the family.

It can take quite a bit of confidence in the process for a professional who is being paid to take their time and to not start by trying to “hit the ground running.” It can take quite a bit of patience on the part of a parent to wait when they think about all of the developmental time that has already been lost. But pushing too hard will create more defensiveness, more anxiety, and more barriers to progress when Floortime is the right prescription for the child (as with any of the methodologies mentioned on this site – I do not maintain that any methodology or therapy is right for everyone).  Floortime is often the best prescription for children that have tremendous anxiety around people or that have lost their trust in others.  Once you make the decision to use Floortime because you think it is the best approach for this individual, then you have made the decision to be exquisitely attuned and to try to join that person on a very deep level. This means unconditional acceptance of their behavior – with the only exceptions being those behaviors that are injurious or otherwise harmful to the person or others or that are unnecessarily destructive (see below).

Particularly important are the admonitions to slow down, to listen and watch extensively before you do anything; to be exquisitely attuned and responsive; to be playful without being intrusive; to use declarative actions without being unnecessarily distracting or expecting too much; to follow the child’s lead radically at first – all that goes double for the avoidant individual

Setting Limits and Dealing with Oppositional Behavior

  • Gently contain aggressive behavior and try to calm and soothe the child first.
  • Show or tell the child you understand what she’s feeling or trying to say, or at least that you are trying to.
  • Once the child is calm, use problem-solving techniques (i.e. “What’s wrong?”  Helping).
  • Biting or pinching or hitting – if the child’s intentions are playful in nature (i.e. to get attention or start an interaction), you should respond warmly.  Make a game or a joke about it, and then model other games to take its place, such as a special greeting, or “High Five,” or use a dinosaur to bite back, etc.